Axillary Block or Wide-awake Local Anesthesia for Complex Regional Pain Syndrome (CRPS) Following Common Hand Surgeries

NCT06866899 | Completed

• 1 other identifier: Axillary block vs Walant
• Study Type: observational
• Target: 98
• Locations: 1 country
• Sites: 1

Brief Summary

Flare reaction, characterized by excessive erythema, stiffness, and edema postoperatively, can lead to complex regional pain syndrome (CRPS) when pain is present. This study compares flare and CRPS incidence following hand surgeries performed under regional anesthesia with axillary block (RAAB) and WALANT (Wide-Awake Local Anesthesia No Tourniquet).

Conditions

CRPS; Walant; Axillary Block

Keywords

CRPS; flare reaction; WALANT; axillary block

Outcome Measures

Primary Outcomes (2)

• CRPS severity score (CSS)

  CRPS: Complex regional pain sydrome The CRPS Severity Score is a composite measure derived from multiple clinical findings, summed to provide a single score ranging from 0 to 16. The ccore is based on four major clinical domains, with each domain contributing 0 to 4 points, leading to a total possible score of 16 points. 1. Sensory Symptoms (0-4 points) Allodynia (Pain due to a stimulus that does not normally provoke pain) Hyperalgesia (Increased pain response to a normally painful stimulus) 2. Vasomotor Symptoms (0-4 points) Temperature asymmetry (≥1°C difference between affected and unaffected limb) Skin color changes (Mottled, red, cyanotic, or pale discoloration) 3. Sudomotor / Edema Symptoms (0-4 points) Abnormal sweating (Hyperhidrosis or hypohidrosis) Edema (Swelling) in the affected area 4. Motor / Trophic Symptoms (0-4 points) Motor dysfunction (Weakness, dystonia, tremors) Trophic changes (Altered nail growth, skin texture changes, or abnormal hair growth)

  Postoperative first month

• CRPS severity score (CSS)

  CRPS: Complex regional pain sydrome The CRPS Severity Score is a composite measure derived from multiple clinical findings, summed to provide a single score ranging from 0 to 16. The ccore is based on four major clinical domains, with each domain contributing 0 to 4 points, leading to a total possible score of 16 points. 1. Sensory Symptoms (0-4 points) Allodynia (Pain due to a stimulus that does not normally provoke pain) Hyperalgesia (Increased pain response to a normally painful stimulus) 2. Vasomotor Symptoms (0-4 points) Temperature asymmetry (≥1°C difference between affected and unaffected limb) Skin color changes (Mottled, red, cyanotic, or pale discoloration) 3. Sudomotor / Edema Symptoms (0-4 points) Abnormal sweating (Hyperhidrosis or hypohidrosis) Edema (Swelling) in the affected area 4. Motor / Trophic Symptoms (0-4 points) Motor dysfunction (Weakness, dystonia, tremors) Trophic changes (Altered nail growth, skin texture changes, or abnormal hair growth)

  Postoperative third month

Secondary Outcomes (2)

• Flare reaction

  Postoperative first month

• Flare reaction

  Postoperative third month

Study Arms (2)

WALANT

Patients operated under WALANT (wide awake local anesthesia without tourniquet)

Procedure: Surgery for Dupuytren contracture (DC), DeQuervain tenosynovitis (DQS), carpal tunnel syndrome (CTS), or trigger finger (TF); Procedure: Local Anesthesia

RAAB

Patients operated under RAAB (regional anesthesia with axillary block)

Procedure: Surgery for Dupuytren contracture (DC), DeQuervain tenosynovitis (DQS), carpal tunnel syndrome (CTS), or trigger finger (TF); Procedure: Regional Anesthesia

Interventions

Surgery for Dupuytren contracture (DC), DeQuervain tenosynovitis (DQS), carpal tunnel syndrome (CTS), or trigger finger (TF) PROCEDURE

All of the patients were operated for Dupuytren contracture (DC), DeQuervain tenosynovitis (DQS), carpal tunnel syndrome (CTS), or trigger finger (TF). The study is two center study, one center has the routine of RAAB (regional anesthesia with axillary block) and the other has the routine of WALANT (wide awake local anesthesia no tourniquet) for the mentioned surgeries.

RAAB; WALANT

Regional Anesthesia PROCEDURE

Regional anesthesia with axillary block

RAAB

Local Anesthesia PROCEDURE

Wide awake local anesthesia no tourniquet

WALANT

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

atients diagnosed with and operated on for Dupuytren contracture (DC), De Quervain tenosynovitis (DQS), carpal tunnel syndrome (CTS), or trigger finger (TF)

You may qualify if:

• Patients diagnosed with and operated on for Dupuytren contracture (DC),
• Patients diagnosed with and operated on for De Quervain tenosynovitis (DQS),
• Patients diagnosed with and operated on for carpal tunnel syndrome (CTS),
• Patients diagnosed with and operated on for trigger finger (TF)

You may not qualify if:

• Patients operated under general anesthesia,
• Patients operated with other types of regional anesthesia (eg: supraclavicular block),
• Patients operated with other types of local anesthesia (only prilocaine or bupivacaine)
• Patients less than 3 months follow up

Sponsors & Collaborators

• Ankara University: lead

Study Sites (1)

Ankara University Medical Faculty

Ankara, Altındağ, 06230, Turkey (Türkiye)

Location

MeSH Terms

Interventions

Surgical Procedures, Operative; Anesthesia, Conduction; Anesthesia, Local

Intervention Hierarchy (Ancestors)

Anesthesia; Anesthesia and Analgesia

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD, Principal Investigator

Study Record Dates

• First Submitted: March 1, 2025
• First Posted: March 10, 2025
• Study Start: January 1, 2021
• Primary Completion: June 1, 2024
• Study Completion: July 1, 2024
• Last Updated: March 10, 2025

Record last verified: 2025-03

Locations

TU (1)